Skin barrier dysfunction measured by transepidermal water loss at 2 days and 2 months predates and predicts atopic dermatitis at 1 year

Abstract Background Atopic dermatitis (AD) is a chronic allergic inflammatory skin disease characterized by complex pathogenesis including skin barrier dysfunction, immune-redox disturbances, and pruritus. Prolonged topical treatment with medications such as corticosteroids, calcineurin inhibitors, and T-cell inhibitors may have some potential side-effects. To this end, many researchers have explored numerous alternative therapies using natural products and mineral compounds with antioxidant or immunomodulatory effects to minimize toxicity and adverse-effects. In the current study, we investigated the effects of mineral complex material (MCM) treatment on 2, 4-dinitrochlorobenzene (DNCB)-induced AD-like skin lesions in SKH-1 hairless mice. Methods Animals were divided into four groups; normal control (NC), negative control treated with DNCB only (DNCB only), positive control treated with DNCB and tacrolimus ointment (PC) and experimental group treated with DNCB and MCM patch (MCM). Skin inflammation and lesion severity were investigated through analyses of skin parameters (barrier score and strength, moisture and trans-epidermal water loss level), histopathology, immunoglobulin E, and cytokines. In addition, reactive oxygen species (ROS), nitric oxide (NO), glutathione peroxidase (GPx), and catalase (CAT) levels were measured in both serum and skin lysate. Results Our results demonstrates that MCM patch improved the progression of AD-like skin lesions by significantly increasing skin barrier strength and decreasing trans-epidermal water loss. Additionally, dermal administration of MCM patch significantly reduced epidermal thickness, ROS, and NO levels in skin lysate. Furthermore, we found that MCM suppressed the levels of AD-involved (Th1 and Th2) cytokines such as IL-2, IFN-γ, and IL-4 in blood. In addition, the levels of other Th1, and Th2 and inflammatory cytokines such as IL-1β, TNF-α, IL-6, IL-12(p70) and IL-10 were found lowest in the MCM group than in the DNCB only and PC groups. Moreover, we found total serum IgE level significantly increased after DNCB treatment, but decreased in the PC and MCM groups. Conclusion Taken together, our findings suggest that MCM application may have beneficial effects either systemic or regional on DNCB-induced AD lesional skin via regulation of the skin barrier function and immune-redox response.

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Skin Barrier Function in Psoriasis and Atopic Dermatitis: Transepidermal Water Loss and Temperature as Useful Tools to Assess Disease Severity

Journal of Clinical Medicine ◽

10.3390/jcm10020359 ◽

2021 ◽

Vol 10 (2) ◽

pp. 359 ◽

Cited By ~ 1

Author(s):

Trinidad Montero-Vilchez ◽

María-Victoria Segura-Fernández-Nogueras ◽

Isabel Pérez-Rodríguez ◽

Miguel Soler-Gongora ◽

Antonio Martinez-Lopez ◽

...

Keyword(s):

Atopic Dermatitis ◽

Disease Severity ◽

Water Loss ◽

Barrier Function ◽

Skin Barrier ◽

Transepidermal Water Loss ◽

Diagnostic Tools ◽

Psoriatic Skin ◽

Skin Barrier Function ◽

Healthy Controls

Multiple diagnostic tools are used to evaluate psoriasis and atopic dermatitis (AD) severity, but most of them are based on subjective components. Transepidermal water loss (TEWL) and temperature are skin barrier function parameters that can be objectively measured and could help clinicians to evaluate disease severity accurately. Thus, the aims of this study are: (1) to compare skin barrier function between healthy skin, psoriatic skin and AD skin; and (2) to assess if skin barrier function parameters could predict disease severity. A cross-sectional study was designed, and epidermal barrier function parameters were measured. The study included 314 participants: 157 healthy individuals, 92 psoriatic patients, and 65 atopic dermatitis patients. TEWL was significantly higher, while stratum corneum hydration (SCH) (8.71 vs. 38.43 vs. 44.39 Arbitrary Units (AU)) was lower at psoriatic plaques than at uninvolved psoriatic skin and healthy controls. Patients with both TEWL > 13.85 g·m−2h−1 and temperature > 30.85 °C presented a moderate/severe psoriasis (psoriasis area severity index (PASI) ≥ 7), with a specificity of 76.3%. TEWL (28.68 vs. 13.15 vs. 11.60 g·m−2 h−1) and temperature were significantly higher, while SCH (25.20 vs. 40.95 vs. 50.73 AU) was lower at AD eczematous lesions than uninvolved AD skin and healthy controls. Patients with a temperature > 31.75 °C presented a moderate/severe AD (SCORing Atopic Dermatitis (SCORAD) ≥ 37) with a sensitivity of 81.8%. In conclusion, temperature and TEWL values may help clinicians to determine disease severity and select patients who need intensive treatment.

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The nonlesional skin surface distinguishes atopic dermatitis with food allergy as a unique endotype

Science Translational Medicine ◽

10.1126/scitranslmed.aav2685 ◽

2019 ◽

Vol 11 (480) ◽

pp. eaav2685 ◽

Cited By ~ 43

Author(s):

Donald Y. M. Leung ◽

Agustin Calatroni ◽

Livia S. Zaramela ◽

Petra K. LeBeau ◽

Nathan Dyjack ◽

...

Keyword(s):

Atopic Dermatitis ◽

Food Allergy ◽

Sampling Method ◽

Skin Barrier ◽

Skin Surface ◽

Transepidermal Water Loss ◽

Barrier Dysfunction ◽

Ceramide Content ◽

Immune Pathways

Skin barrier dysfunction has been reported in both atopic dermatitis (AD) and food allergy (FA). However, only one-third of patients with AD have FA. The purpose of this study was to use a minimally invasive skin tape strip sampling method and a multiomics approach to determine whether children with AD and FA (AD FA+) have stratum corneum (SC) abnormalities that distinguish them from AD without FA (AD FA−) and nonatopic (NA) controls. Transepidermal water loss was found to be increased in AD FA+. Filaggrin and the proportion of ω-hydroxy fatty acid sphingosine ceramide content in nonlesional skin of children with AD FA+ were substantially lower than in AD FA− and NA skin. These abnormalities correlated with morphologic changes in epidermal lamellar bilayer architecture responsible for barrier homeostasis. Shotgun metagenomic studies revealed that the nonlesional skin of AD FA+ had increased abundance of Staphylococcus aureus compared to NA. Increased expression of keratins 5, 14, and 16 indicative of hyperproliferative keratinocytes was observed in the SC of AD FA+. The skin transcriptome of AD FA+ had increased gene expression for dendritic cells and type 2 immune pathways. A network analysis revealed keratins 5, 14, and 16 were positively correlated with AD FA+, whereas filaggrin breakdown products were negatively correlated with AD FA+. These data suggest that the most superficial compartment of nonlesional skin in AD FA+ has unique properties associated with an immature skin barrier and type 2 immune activation.

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Skin barrier status during dupilumab treatment in patients with severe atopic dermatitis

Therapeutic Advances in Chronic Disease ◽

10.1177/20406223211058332 ◽

2021 ◽

Vol 12 ◽

pp. 204062232110583

Author(s):

Silvia Ferrucci ◽

Maurizio Romagnuolo ◽

Carlo Alberto Maronese ◽

Francesca Germiniasi ◽

Simona Tavecchio ◽

...

Keyword(s):

Atopic Dermatitis ◽

Skin Barrier ◽

Transepidermal Water Loss ◽

Response To Therapy ◽

Interleukin 4 ◽

Severe Atopic Dermatitis ◽

Barrier Dysfunction ◽

Relative Variation ◽

Good Tool ◽

The Status

Background: Atopic dermatitis (AD) is a common chronic-relapsing inflammatory skin disease hallmarked by epidermal barrier dysfunction, increased transepidermal water loss (TEWL) and decreased skin hydration. Recent findings on the T helper 2 (Th2)-driven pathogenesis of AD have led to the development of dupilumab, a monoclonal antibody directed against interleukin-4 and interleukin-13 that has been demonstrated to be effective in the treatment of moderate-to-severe AD. The effect of dupilumab on skin barrier dysfunction, however, has not yet been adequately investigated. Objectives: The primary endpoint of this study was to assess the status of the skin barrier in nonlesional skin of patients with severe AD treated with dupilumab, by evaluating the association between the relative variation of TEWL and the achievement of a 75% reduction of EASI (EASI75) over time. Methods: TEWL was measured below the antecubital fossae by means of the Vapometer® at baseline, at week 4 (T4), at week 16 (T16) and at week 32 after dupilumab starting. EASI and NRS-itch were measured at the same time points. Results: Seventy-eight patients with severe AD treated with dupilumab were enrolled. Median TEWL relative variation respect to baseline was significantly higher in patients who achieved EASI75 as compared with those who did not achieve EASI75 at T16 and at T32, but not at T4. Conclusion: During dupilumab treatment, TEWL on nonlesional skin tends to significantly improve 4 months after treatment initiation and could be a good tool for monitoring response to therapy.

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Biophysical parameters of rats’ skin after the administration of methimazole

Bulletin of the Veterinary Institute in Pulawy ◽

10.2478/bvip-2014-0049 ◽

2014 ◽

Vol 58 (2) ◽

pp. 315-319 ◽

Cited By ~ 3

Author(s):

Marcin Gołyński ◽

Marcin Szczepanik ◽

Krzysztof Lutnicki ◽

Łukasz Adamek ◽

Magdalena Gołyńska ◽

...

Keyword(s):

Oral Administration ◽

Water Loss ◽

Wistar Rats ◽

Skin Barrier ◽

Transepidermal Water Loss ◽

Skin Hydration ◽

Barrier Dysfunction ◽

Early Assessment ◽

Biophysical Parameters ◽

Ph Measurements

Abstract The paper describes the influence of oral administration of methimazole on biophysical skin parameters. Wistar rats of different sex (220-260 g) were used in the experiment. Biophysical skin parameters, such as transepidermal water loss (TEWL), corneometry, and pH were examined at seven-day intervals. Significant changes in the parameters were observed on the 7th d of methimazole administration. The changes were observed in both sex but males appeared to be less sensitive in that respect. Changes in the parameters in the females showed rapid mechanisms, which normalised transepidermal water loss and skin hydration, as well as restored skin barrier functions. TEWL, skin hydration, and skin pH measurements allow an early assessment of skin barrier dysfunction after administration of this drug.

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Measurement of transepidermal water loss ( TEWL ) in cats with experimental skin barrier dysfunction using a closed chamber system

Veterinary Dermatology ◽

10.1111/vde.12361 ◽

2016 ◽

Vol 27 (5) ◽

pp. 428 ◽

Cited By ~ 3

Author(s):

Yutaka Momota ◽

Kenichiro Shimada ◽

Azusa Gin ◽

Takako Matsubara ◽

Daigo Azakami ◽

...

Keyword(s):

Water Loss ◽

Skin Barrier ◽

Transepidermal Water Loss ◽

Chamber System ◽

Barrier Dysfunction ◽

Closed Chamber

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Echinochrome A Treatment Alleviates Atopic Dermatitis-like Skin Lesions in NC/Nga Mice via IL-4 and IL-13 Suppression

Marine Drugs ◽

10.3390/md19110622 ◽

2021 ◽

Vol 19 (11) ◽

pp. 622

Author(s):

Hyeong Rok Yun ◽

Sang Woo Ahn ◽

Bomin Seol ◽

Elena A. Vasileva ◽

Natalia P. Mishchenko ◽

...

Keyword(s):

Atopic Dermatitis ◽

Clinical Symptoms ◽

Sea Urchins ◽

Skin Barrier ◽

Skin Lesions ◽

Transepidermal Water Loss ◽

Interleukin 4 ◽

Barrier Dysfunction ◽

Echinochrome A ◽

Anti Inflammatory

Atopic dermatitis (AD) is a chronic inflammatory skin disease in which skin barrier dysfunction leads to dryness, pruritus, and erythematous lesions. AD is triggered by immune imbalance and oxidative stress. Echinochrome A (Ech A), a natural pigment isolated from sea urchins, exerts antioxidant and beneficial effects in various inflammatory disease models. In the present study, we tested whether Ech A treatment alleviated AD-like skin lesions. We examined the anti-inflammatory effect of Ech A on 2,4-dinitrochlorobenzene (DNCB)-induced AD-like lesions in an NC/Nga mouse model. AD-like skin symptoms were induced by treatment with 1% DNCB for 1 week and 0.4% DNCB for 5 weeks in NC/Nga mice. The results showed that Ech A alleviated AD clinical symptoms, such as edema, erythema, and dryness. Treatment with Ech A induced the recovery of epidermis skin lesions as observed histologically. Tewameter® and Corneometer® measurements indicated that Ech A treatment reduced transepidermal water loss and improved stratum corneum hydration, respectively. Ech A treatment also inhibited inflammatory-response-induced mast cell infiltration in AD-like skin lesions and suppressed the expression of proinflammatory cytokines, such as interferon-γ, interleukin-4, and interleukin-13. Collectively, these results suggest that Ech A may be beneficial for treating AD owing to its anti-inflammatory effects.

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‘Barrier dysfunction in Atopic newBorns studY’ (BABY): protocol of a Danish prospective birth cohort study

BMJ Open ◽

10.1136/bmjopen-2019-033801 ◽

2020 ◽

Vol 10 (7) ◽

pp. e033801

Author(s):

Trine Gerner ◽

Anne-Sofie Halling ◽

Maria Rasmussen Rinnov ◽

Nina Haarup Ravn ◽

Mette Hjorslev Knudgaard ◽

...

Keyword(s):

Atopic Dermatitis ◽

Cohort Study ◽

Birth Cohort ◽

Skin Barrier ◽

Transepidermal Water Loss ◽

Birth Cohort Study ◽

Tape Stripping ◽

Barrier Dysfunction ◽

Prospective Birth Cohort ◽

Prospective Birth Cohort Study

IntroductionSkin barrier development and dysfunction in premature and mature newborns is important for the risk of atopic dermatitis (AD).Methods and analysisThe Barrier dysfunction in Atopic newBorns studY (BABY) Cohort is a prospective birth cohort study of 150 preterm children (gestational age (GA) below 37+0) and 300 term children (GA 37+0 to 41+6). Skin barrier is assessed through transepidermal water loss, tape stripping, Raman-spectroscopy and microbiome sampling. Clinical examinations are done and DNA from buccal swabs is collected for genetic analyses. Thymus size is assessed by ultrasound examination. Information on pregnancy, delivery, parental exposures and diseases are collected, and structured telephone interviews are conducted at 18 and 24 months to assess exogenous exposures in the child and onset of AD. Hanifin and Rajka criteria as well as The UK Working Party's Diagnostic Criteria for Atopic Dermatitis are used to diagnose AD. Severity of AD is assessed using the Eczema Area and Severity Index (EASI) and Patient Oriented Eczema Measure (POEM).Ethics and disseminationThe study is approved by the scientific Ethical Committee of the Capital Region (H-16042289 and H-16042294).Outcomes will be presented at national and international conferences and in peer-reviewed publications.

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Role of skin microbiome in epidermal barrier dysfunction and development of atopic dermatitis in high risk infants

Rossiiskii Allergologicheskii ZHurnal ◽

10.36691/rja26 ◽

2019 ◽

Vol 16 (1) ◽

pp. 59-64

Author(s):

N B Migacheva

Keyword(s):

At Risk ◽

Atopic Dermatitis ◽

Skin Barrier ◽

Transepidermal Water Loss ◽

Skin Microbiome ◽

Children At Risk ◽

Barrier Dysfunction ◽

Epidermal Barrier ◽

Microbiome Composition

Background. Colonization of skin with S. aureus in atopic dermatitis (AD) patients is a widespread phenomenon and a factor complicating the course of the disease. At present, it is not quite clear the role of S. aureus in the development of AD in children at risk. The aim of our study was to discribe the skin microbiome composition in young children at risk, as well as to investigate the role of S. aureus in skin barrier dysfunction and the development of AD. Material and methods. 12months follow-up study of 37 infants at risk has been performed. It included a general clinical examination, a microbiological investigation of skin microbiome (at 1 and 6 months), and investigation of epidermal barrier function by determining the transepidermal water loss (TEWL) at 1, 3, 6 and 12 months. Realization of AD during the observation period was considered as main outcome. Results. The prevalence of S. aureus colonization of infants aged 1 month was 45.9%, at the age of 6 months - 29.7%. Correlation analysis revealed an association between the skin colonization with S. aureus and a decrease of TEWL (p = 0.004), as well as the cumulative incidence of AD (p

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